<style>
    body,html{
        background-color: #F9F9F9;
    }
    .xh-area-form table tr td {
        padding: 10px;
    }
    .modal-body{
        padding: 5px;
        margin-top: 20px;
        margin-left: 10px;
    }
</style>
<form id="xh_form" class="xh-form"  method="post" >
    <div class="xh-area-form">
        <table style="border-collapse:separate; border-spacing:0px 10px;">
            <tr>
                <td style="width: 75px;">
                    <label>居住人</label>
                </td>
                <td style="width: 200px;">
                    <input type="text" name="sOperator" autocomplete = 'off'>
                </td>
                <td><label>联系电话</label></td>
                <td ><input type="text" name="sAgencyPhone" autocomplete = 'off'></td>
                <td><label>住址类型</label></td>
                <td>
                    <select id="iType" name="iType" style="width: 200px;">
                        <option value="">请选择</option>
                        <option value="1">家</option>
                        <option value="2">学校</option>
                    </select>
                </td>
            </tr>
            <tr>
                <td style="width: 75px;"><label>省</label></td>
                <td style="width: 200px;">
                    <select  id="iProvince" name="iProvince" targetFormat="sProvince" style="width: 200px;">
                        <option value="">请选择</option>
                        {% if province is not empty %}
                            {% for item, value in province %}
                                <option value="{{ item }}">{{ value['areaName'] }}</option>
                            {% endfor %}
                        {% endif %}
                    </select>
                    <input type="hidden" name="sProvince">
                </td>
                <td style="width: 75px;"><label>市</label></td>
                <td style="width: 200px;">
                    <select  id="iCity" name="iCity" targetFormat="sCity" style="width: 200px;" >
                        <option value="">请选择</option>
                    </select>
                    <input type="hidden" name="sCity">
                </td>
                <td style="width: 75px;"><label>区</label></td>
                <td style="width: 200px;">
                    <select  id="iCounty" name="iCounty" targetFormat="sCountry" style="width: 200px;" >
                        <option value="">请选择</option>
                    </select>
                    <input type="hidden" name="sCounty">
                </td>
            </tr>
            <tr>
                <td><label>详细地址</label></td>
                <td colspan="5"><input type="text" name="sAddress" autocomplete = 'off'></td>
            </tr>
            <tr>
                <td style="width: 75px;"><label>运营区</label></td>
                <td style="width: 200px;">
                    <select  id="iSecArea" name="iSecArea"  style="width: 200px;">
                        <option value="">请选择</option>
                        {% for id,text in secArea %}
                            <option value="{{ id }}">{{ text }}</option>
                        {% endfor %}
                    </select>
                </td>
                <td style="width: 75px;"><label>运营县</label></td>
                <td style="width: 200px;">
                    <select  id="iThirdArea" name="iThirdArea" style="width: 200px;" >
                        <option value="">请选择</option>
                    </select>
                </td>
            </tr>
            <tr>
                <td valign="middle"><label>备注</label></td>
                <td colspan="5"><textarea border="0" name="mDesc" rows="3" autocomplete = 'off'></textarea></td>
            </tr>
        </table>
    </div>
</form>